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General NPI Number Information
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NPI Number | 1619373834
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Entity Type | Organization
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Legal Business Name | COUPLES THERAPY SERVICES
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Dates
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Enumeration Date | 11/16/2014
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Last Update Date | 11/16/2014
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Provider Practice Location Address
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Address Line | 180 TULIP LN
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City | FREEHOLD
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State | NJ
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Zip | 07728-4097
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Country | US
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Telephone | 732-804-4314
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Fax |
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Provider Business Mailing Address
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Address Line | 168 FRANKLIN CORNER RD STE B210
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2529
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Country | US
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Telephone | 732-804-4314
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. BRIANNA P BRUNNER
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Credential | LCSW
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Telephone | 732-804-4314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05522300
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License Number State | NJ
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